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In the name of Darwinian eugenics, Enterprise withholds a cure from a culture that has been stricken by a planet-wide plague. Billions suffer. If you suspect your friends came from the mirror universe, ask them if they think this is a happy ending.

Contents

DoctorPhlox is taking care of the various creatures he keeps in the med lab. Hoshi Sato enters bearing a letter from Phlox's exchange doctor, Jeremy Lucas, who is serving a term on his home planet. The rigors of the mating season are making things very difficult for the exchange doctor.

Phlox begins to compose a letter describing his experiences with the crew, commenting on the many differences between his own society and point of view, and the ways in which Humans are different. Phlox shares that he thinks a crew member, Elizabeth Cutler, has a romantic interest in him.

On the bridge, the crew are discussing a pre-warp vessel they have encountered. It is not responding to hails, and has two weak bio-signs on board. They dock the vessel in Bay 2 and take the aliens to their medical bay. The alien they speak with begs them to assist with a medical emergency their species is facing. They are a pre-warp culture known as the Valakians. They have met two warp-capable species, one of which is the Ferengi. T'Pol reveals that the Vulcans are unaware of either species. She states that as the Valakian culture has already been exposed to a couple of warp-capable races, the risk of cultural contamination is acceptable, and she agrees with Archer to help them.

Phlox continues his letter describing the situation, stating it as the greatest challenge he has faced – with over fifty million lives at stake.

Sato and Phlox discuss the issue of crewman Cutler having a romantic interest over dinner (in English and Denobulan). Sato says she thinks they'd make a good couple.

The Enterprise arrives at the Valakian homeworld. T'Pol, Phlox, Archer, and Sato make a tour of the medical facility. Sato discovers that there is a second race, the Menk, which live alongside the Valakians. The Menk are apparently not affected by the disease.

Phlox continues his letter, describing the challenges of treating the disease, and his discussions with T'Pol about the possibilities of inter-species relationships.

Phlox makes the startling discovery that the Valakians are dying not from an easily curable medical condition, but because of a genetic disease which is experiencing an accelerated rate of mutation. He reveals this to Captain Archer, and states that he does not have confidence in curing it. He predicts that the Valakians will be extinct within two centuries.

Phlox describes how studying two humanoid cultures simultaneously is exciting. He continues that while he looks forward to the medical data, he finds the way that the two cultures live in harmony to be amazing. The Menk must live where the soil is not good for planting, despite the fact that the Menk culture is fairly agrarian. The Menk continue to state that the Valakians treat them well. The Valakians say that they can farm the land more efficiently with better technology, and just give the Menk whatever they need. Sato is upset and thinks that the Valakians are oppressing the Menk and treating them like "pets", but Phlox says that she is making assumptions based on Human history: from Phlox's perspective, the Valakians and Menk have found a way to live in harmony, when on most planets with more than one sentient race, they fight each other until only one survives. Phlox, Sato, and Cutler discover (while studying at one of the Menk settlements) that the Menk are actually surprisingly advanced – they demonstrate that they are able to learn some English, and organize tissue samples correctly.

After a long day of work, the group takes some time to pack up. Sato excuses herself to let Phlox and Cutler have some private time. Phlox reveals to Cutler that he has three wives, and each of those wives has three husbands including himself. He asks Cutler if she is interested in him romantically, or if he has been misinterpreting the signals. Cutler confirms that she was giving off romantic signals. She replies that she is not looking to become wife #4, but she's interested in Phlox as a friend, and is ready to see where it leads (hinting that a romantic relationship may indeed be on the horizon).

Archer visits, in the hospital, the first alien he rescued. The alien asks Archer for warp drive technology so that that if Enterprise cannot find a cure, the Valakians can search for other races who might be willing to help them. Archer returns to the ship to learn that Enterprise has received 29 hails and requests for help from other clinics, and has been approached by a couple of vessels, all of whom thought they already had a cure. Archer and T'Pol discuss the situation in the ready room. Archer tells T'Pol that he is reluctant about trying to teach the Valakians about warp drive: they do not possess much rudimentary knowledge about warp technology, and have almost no experience working with anti-matter, an essential part of the process. It would take years if not decades to teach the Valakians how to develop their own warp-capable ships. As T'Pol points out, the Vulcans stayed on Earth to help them along, but generations later they are still there. Archer tells T'Pol that he understands now how the Vulcans felt when they chose to contact Earth ninety years before.

Later that evening, Archer is mulling over the situation in the crew mess. Phlox enters and makes small talk (revealing that Denobulans hibernate for six days each year). Archer asks about the progress of Phlox's medical research. Phlox says that he thinks it is incorrect to be helping the Valakians – that the Menk are supposed to survive, and will only be allowed to properly evolve and prosper if they are not tied to the Valakians. Phlox explains that the "disease" is actually an inherent flaw in Valakian DNA; they've reached an evolutionary dead end. Archer demands a cure for the Valakians, saying he doesn't agree with Phlox's point of view. Phlox reveals that he already has a cure.

The next day, Archer enters the medical facilities. Phlox tries to again state that he does not believe that they should interfere with the natural pace of events on the planet. Archer cuts him off, and makes the statement that he has reconsidered the matter, and that he agrees that the Enterprise and the Human race did not go to the stars to play god for other species. They go down to the planet and give the Valakian doctors a medicine which will ease the symptoms and help them. They state they won't give them a warp drive, that their race must help itself.

Finishing off his letter to Doctor Lucas, Phlox expresses relief that he could trust Captain Archer with the results of his research, and that he wished the Vulcan diplomats had acted in a similar manner in letting the Humans make their own decisions over the past ninety years.

Sato enters to take the letter away, and suggests that he should take a break. Phlox contacts Cutler and asks her on a meal date in the mess hall.

"The captain has committed all our resources to helping people he didn't even know existed two days ago. Once again, I'm struck by your species' desire to help others."

- Phlox, in his letter to Jeremy Lucas

"Your experience with lesser civilizations is limited, captain. You might be surprised what a temptation our technology can be."

- T'Pol, to Archer

"We could stay and help them."
"The Vulcans stayed to help Earth 90 years ago. We're still there."
"I never thought I'd say this, but... I'm beginning to understand how the Vulcans must have felt."

- Archer and T'Pol

"What do you suggest? We choose? One species over the other?"
"All I'm saying is we let nature make the choice."
"To hell with nature. You're a doctor, you have a moral obligation to help people who are suffering."

- Archer and Phlox

"My compassion guides my judgement."

- Archer to Phlox

"Evolution is more than a theory. It is a fundamental scientific principle."

- Phlox, to Archer

"Someday my people are going to come up with some sort of a doctrine: something that tells us what we can and can't do out here – should and shouldn't do. But until somebody tells me that they've drafted that directive, I'm going to have to remind myself every day that we didn't come out here to play God."

- Captain Archer

"I'd like to think, Dr. Lucas, that if I'd had the chance to talk to you face to face you'd have never let me even consider withholding my findings from the captain, but I'm ashamed to say that I almost did just that. [...] If I hadn't trusted him to make the right choice, I'd have been no better than the Vulcan diplomats who held your species back because they felt you couldn't make proper decisions on your own. I came very close to misjudging Jonathan Archer, but this incident has helped me gain a new respect for him."

This episode originally ended with Phlox disobeying Archer's orders. ("To Boldly Go: Launching Enterprise, Part III: First Flight", ENT Season 1 Blu-ray special features) Phlox actor John Billingsley offered, "In the original ending in this crisis of conscience, the Doctor essentially does something that violates the standard issue hierarchical obligations of a crewmember to his captain. In effect, he makes a decision that's rooted in 'I've got bigger fish to fry', rather than honoring his captain's wishes." [1]

The final draft script of this installment was submitted on 22 October2001. In that version, Phlox discovers a cure for the Valakian plague but keeps it secret from Captain Archer. He firstly tells the captain he will "do [his] best" to find a cure for the virus but then, in a subsequent scene with Archer and T'Pol, Phlox lies to them that the Valakians' genetic structuring is "too fragile" to be tampered with. Though Archer considers the Vulcans thereafter searching for a cure, T'Pol comments that the Vulcans' medical techniques are no more advanced than Phlox's. Urged by T'Pol to depart from the planet since it seems they can do no more to help the Valakians, the three officers meet with Esaak in the hospital and Archer gives him a case full of medical ampules, telling the Valakian doctor they will "keep your species healthy for another three generations." On a shuttlepod journey back to Enterprise, Phlox admits the truth to Dr. Lucas, in voiceover dialogue, stating, "I couldn't bring myself to alter the evolutionary process on this planet. I consider myself a man who values human compassion... but I find myself, in this case, a slave to Vulcan logic. Have I made the right decision? I suspect I'll be asking myself that question for many years to come." A more minor change from the final version of the episode is that, after Phlox has a discussion with Hoshi and exits sickbay, a final view of Enterprise at warp was to be shown, though this doesn't appear in the episode's final edit.

The network UPN wanted the ending of this episode changed. Billingsley related, "The head of the studio [Paramount Pictures] suggested some revisions on the ending [....] The network essentially felt that [...] it was important to essentially make sure that everyone was here to support the captain's decisions." [2] The episode was subsequently altered. Clarified Brannon Braga, "The studio made us change the ending." ("To Boldly Go: Launching Enterprise, Part III: First Flight", ENT Season 1 Blu-ray special features)

John Billingsley was not fond of how this episode's conclusion was modified. "The ending that had initially been created (for the episode) I was fairly comfortable with [....] What do you do? I wasn't as happy with the revisions, but it's not my show," he reflected, "you have to sort of adjust, even if sometimes it does seem a bit of a contradiction in terms for what your character is supposed to be about [....] Personally, I thought [about the network's decision], 'Well, I think you've kind of lost something interesting in this potential tension.' But, that's not my call." [3]

Looking back on the series in 2006, John Billingsley nominated this episode as one of his favorites, and a turning point in the development of Phlox. "I would say that I still have the fondest feelings for the episode 'Dear Doctor' in the first season because that was the first opportunity I had to actually begin to figure out how to three dimensionalize that character. It was the first episode I really had a lot to do and we began to see there was more to this guy than 'Hey fellow well met' which was the concern I'd had up to that point, that Phlox was going to essentially be the cheery fellow who has always got a little alien quirk to make us laugh." [4]

At one point during the production of this installment, John Billingsley used the episode's voiceover aspect to play a prank on Archer actor Scott Bakula. "The way we managed to make sure that the image, the picture, lasted long enough to match the dialogue is we pre-recorded the dialogue and played it over the scene as we acted it," explained Billingsley. "So, I asked them if they would allow me just to record some fake dialogue. So, the scene with me standing on the bridge, I was supposed to say something of the effect of, 'Isn't it marvelous the way these Humans are so kind and considerate, stopping to help people in need here in the middle of space?' Instead I said, 'Doesn't the captain look nice in that tight suit? Mmm. I wonder if he's wearing any underwear. My, how I'd like to get him somewhere off to myse–' Anyway, I went on in this vein, and everybody broke up." ("O Captain! My Captain! A Profile of Scott Bakula", ENT Season 1 DVD & Blu-ray special features)

In a 2011 interview, Brannon Braga characterized this episode as an early Enterprise installment "that I really loved, that I thought was a classic." He went on to say, "It was just a great episode of Star Trek. That's one I look at fondly." [5] Braga further commented, "For a Star Trek episode to work, like 'Dear Doctor', it's gotta have a conceptual hook that's fresh, it's gotta have some sort of moral spine, and something that engages all the characters, most of the characters, in some interesting way. And if you look at that one, everyone's got a moment [....] I thought 'Dear Doctor' was by far the best episode of the season. And it was very specific to Enterprise [....] It dealt with a real issue. It had it all. It was charming, it was funny, it was well-paced, it had a good framing device, and it ended up [...] dealing with a really good issue you'd never seen dealt with before. That's Star Trek at its best [....] I wish they'd all been 'Dear Doctor's that first season." ("To Boldly Go: Launching Enterprise, Part III: First Flight", ENT Season 1 Blu-ray special features)

This episode achieved a Nielsen rating of 3.7 and was watched by an average of 5.65 million viewers. [6]

The unofficial reference bookBeyond the Final Frontier (p. 364) regards this episode as having helped set the character of Phlox apart from that of Neelix, commenting, "This episode shows that [John Billingsley's] [...] a talented and versatile actor, and his character has hidden depths and secrets (but thankfully not sinister ones). The plot – a population affected by a terrible plague that's afflicted them for generations which a single Starfleet medical officer can cure in a day or two – isn't original, but it isn't really the point of a genuinely character-driven episode."